BACKGROUND: Several methods have been used for the treatment of pediatric distal radius fractures, such as the elastic stable intramedullary nail (ESIN), Kirschner wire (K-wire), and plate, but there has been no consensus about the optimum method. The purpose of this study was to compare ESIN and K-wire techniques used in metaphyseal-diaphyseal junction (MDJ) fractures of the pediatric distal radius.
METHODS: The data of patients who were treated at a children\'s hospital affiliated with Shandong University between August 2018 and January 2022 were analyzed retrospectively. The children were divided into the ESIN and K-wire groups. Clinical outcomes were measured by the Gartland and Werley scoring system. Variables were analyzed using a statistical approach between the two groups.
RESULTS: The study included 26 patients, of whom 11 were treated with K-wire and 15 with ESIN. At the final follow-up, all of the fractures were healed. There were no differences in terms of age, sex, fracture location, or wrist function score. However, the ESIN was superior to K-wire in operative time, fluoroscopic exposure, and estimated blood loss (EBL).
CONCLUSIONS: K-wire and ESIN are both effective methods in the treatment of MDJ fractures of the pediatric distal radius. The use of the ESIN technique represents less EBL, fluoroscopy exposure, and operation time compared with K-wire. We recommend osteosynthesis by ESIN rather than K-wires in patients with MDJ fractures of the distal radius.
METHODS: III, a case-control study.

UNASSIGNED: Although there are few descriptions in textbooks and it is stated that the treatment of metaphyseal-diaphyseal junctional (MDJ) fracture is difficult, there is almost no detailed description on its treatment methods and precautions.
UNASSIGNED: We encountered two patients, 9-year-old and 1-year and 11-month-old Japanese boys, with MDJ fractures of the distal humerus, which are very rare in children. Unlike supracondylar fractures of the distal humerus, the fractures were spiral fractures, which made percutaneous pinning very difficult. Open reduction was performed using a bilateral approach with two skin incisions. Both patients recovered completely and had no problems carrying out activities of daily living or playing sports.
UNASSIGNED: For patients that are old enough to receive a locking plate, we recommend fixation using a locking plate. In cases of unilateral pinning without cross-pinning, retrograde intramedullary nailing should be considered. MDJ fractures of the distal humerus should be treated as distal humeral shaft fractures, not as subtypes of supracondylar fractures of the humerus.